Time To Upgrade My Perimenopause Plan (don’t open if your own MH a bit iffy)

[AlienatedChildGrown]

… Just to clarify. In order to explain I’ll have to use terminology that I know I found could jar me into a fat worse state when my mental health issues were untreated. And please don’t feel you should read and post despite that in order to give support. I’m OK. I’ve got this under control. I just need some technical/medical signposting rather than empathy and understanding.

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Right. Diagnosed with ADHD, depression and perimenopausal symptoms when 48. Now 55. Only other health issue is small holes in brian due to covid, which caused a TIA in 2020. Memory back to mostly normal.

Accepted the ADHD diagnosis. Refused medication. Did not accept other diagnosis’s cos… stubborn.

2020 Post covid making holes in my brain, with an 8 month recovery in front of me, accepted the depression diagnosis. Accepted medication. Worked wonders in a few months.

Post vaccination periods went all over the place, I was having too many of them. Then disappeared for a while. Returned to monthly. Then longer gaps. Couldn’t tell if they were right about perimenopause or it was extended covid high jinx. Cos they went berserk after every covid vax (had three). Talked to GP a couple of months ago, he deffo on the side of perimenopause but won’t consider HRT unless I submit to a pelvic exam. Can’t do that. My then GP sexually assaulted me after he made me get naked at 17 years old. I have no idea how I got through pregnancy and childbirth (c-section in the end). I just know I won’t have anybody medical down there. So kicked it into the long grass.

For just over a year, thanks to the ADs my mood baseline was good enough to work with. I’ve used an app for better routines of self care, diet, daily exercise, meditation. Been amazing. Never felt better. No seriously, mind, body and soul better than it’s been since 1984. Carried on ignoring potential perimenopause kicking up a notch.

48 hours ago woke up to find suicidal ideation had returned with a bang. Been completely absent from my life since the ADs kicked in over a year ago. Mood very very low. So did the normal, Daily Stoic, Water, Breakfast, Gratitude, took dog for a good walk (live in the Italian countryside). Then for the first time ever, the ideation went from impossible acts, to very specific and very near where I was walking. Took dog home. Did all the CBT squashing work. But I’m shaken up. I’d forgotten how low the lows can go. And despite near constant suicide ideation since 1984, it’s always been of the distant undoable type. Not like a realistic idea.

I’m fine, mood stabilised as I suddenly started spotting last night. Light period turned up during the night. Been about 7 weeks since the last one. But I’m not risking a rerun of that. Not cos I’m going to do it, I’m not. Got a kid, a husband .. and my poor sister would never recover. But they can’t live as they are now if I go to that dark place every couple of months. And fucking hell, I don’t want back down there either. I’m genuinely shaken up at how cold, low, dark and scary it was when my mood suddenly dropped like a stone.

I’ll organise an online consult for the prescription with a private doc. Cos I’m not submitting to a pelvic exam, and I’m at the top range possible already for antidepressants. Higher than the GP likes. But he doesn’t have to live in my head when the dose is lower.

But can I have the short and sweet of what HRT products any of you have have found to have a good impact on mood stabilisation. I’ve got a good handle on the other stuff (so far, we’ll see what the next erratic cycle chucks at me, I might change my mind), but I think I’m going to have to bite the HRT bullet sooner rather than later.

I repeat. I’m OK. The mood has risen, the intrusive thoughts gone. Dealt effectively with them at the time and will do so again if they have another go at me. But I do need to get my skates on and not kick the menopause into the long grass anymore.

Cos the fucker evidently doesn’t want to stay there and keep being ignored via the great diet, exercise, anti depressants, meditation and mindfulness routine. It’s bringing the really big guns and I need to fight back with superior weaponry. I did not work my arse off to FINALLY get to a really good place, just for my poxy hormones to have a mass protest and try to snatch it all away from me.

Just a really quick point and sorry if you k now this already but using Utrogestan vaginally is supposed to avoid the sedative effects.

It's not metabolised in the digestive system which means it works locally in the vagina and is absorbed through the cervix into the uterus.

I've used it for years both orally and vaginally. I do get some side effects vaginally- actually more 'awake' at night- but everyone is different.

Hope you continue to feel better.

I'm so pleased for you.

Your effort, determination, bravery and self awareness are inspiring.

Well done you. You should be very proud.
Long may the good times roll.

Delighted to read your update, @AlienatedChildGrown .

OP - I don't know if you are still posting but I found your thread through searching menopause and Italy. I am in an eerily similar situation to you! My local medical centre will only talk about HRT if I have the dreaded exam - and it has to be with the male doctor. Crap. I am now planning on going private instead and will see how that goes. BTW I don't know where you are but my local screening programme now lets you do the cervical screening on your own at home if that helps. Did you get the ADHD diagnosis in Italy? Currently looking into this for DS but people keep warning me against it....

@Cappuccinfortwo My thyroid decided to join the “everything is falling apart” party, and through that I discovered our local private blood test clinic. They were so lovely and gentle that I’m going there for a smear test in a couple of weeks. Based on my pathetic attempts to self test for Covid I don’t think I’d manage well self testing my cervix.

I got diagnosed with ADHD via my GP & ASL. GP referred me via the public health system for a psych visit (for a full on nervous breakdown). I think it was just a couple of weeks wait for the initial appointment, cos they fast tracked me. The final and full diagnosis was ADHD, depression (which I disputed, cos I’m daft) and cyclothymic disorder (which I renamed Moody Cow disorder). But the only treatment offered was antidepressants. Which I refused (cos I’m daft).

At the time there were no approved ADHD meds for adults in Italy. One has been approved now, Strattera (spelling ?). But it is contraindicated with the antidepressant I’m taking, so I’ve just carried on with the strategies, lifestyle and attitudinal changes that helped from the start. There’s no way I’m going to mess with my antidepressants for the sake of a “maybe it’ll help” with Strattera.

I think I got lucky with my GP and hit gold with the psych. He was very on the ball. There is a society for adult ADHD over here with a list of centres. I’ll see if I can dig it out of link list for you.

Big fat hug. Cos it’s hard enough without adding doing everything in a second language to the mix 🤗

.... and typically missed that it was for your DS. I think there are far more meds available for kids. Certainly more options for diagnosis and management.

I wish I had known I had it as a child. I could have done with strategies that were less based on despising myself for being “crap at everything”.

@AlienatedChildGrown Thanks. Tbh I wouldn't be surprised if I have it too but I am still in the denial phase ("I just need a kick up the arse/more exercise/ another to-do list" in order to get my act together!") Unfortunately this hasn't worked for the last 40 years but la speranza è sempre l'ultima a morire! 😆

… and its heart keeps beating away, thinking the Magic Bullet app/quote/book is just around the corner even after diagnosis 😅

It’s just The Man & The Boy remember I have ADHD even when I forget and manage to haul me out of my latest rabbit hole before I lose an entire week.

The strategies are great, they’ve made my life so much better. I just regularly take issue with them being something I have to keep plugging away. Cos what I really want is a magic wand, once and done, kind of thing.

How's it going @AlienatedChildGrown ? Is the HRT still working for you? I really need to sort it out soon. Last month I hit a really low low until my errant period arrived and my brain finally remembered about hormones...

Gave up on male gynae (the only one who is qualified in our consultorio to prescribe HRT!) as I didn't want the exam. I found a (200 euro!!) gynae who is open to the idea but she prescribed a mix of going on the pill plus a smidge of testosterone- which you can't buy over the counter as it's now considered doping and so there is some very complicated procedure for getting it which is just too much to get my head around at the moment. Not sure what to do next.

Also has anyone else been told to take testosterone? She says it will help with memory problems and my general lack of oomph! I am worried it will hasten the demise of my thinning hair and possibly make me angrier than I already am.

I’m so sorry you have been going through all this. I was prescribed Evorel patches (oestrogen only hrt because I had a fresh Mirena) over the phone - no internal exam even mentioned. For what?? I would ask to see a different GP at your practice.

@DarkAcademia Thanks. I am in Italy though and there is only one GP. It is a private gynae who prescribed the pill/testosterone as I can't find anyone who will prescribe "normal" HRT until I am in full menopause and I can't wait that long!

I have just read the thread on testosterone though and it sounds like it works for a lot of women. Am an idiot for not sorting this before as she says I must start on the first day of the period and who knows when the next one will be ?